<form id="edit-form" class="form-horizontal" role="form" data-toggle="validator" method="POST" action="">

    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Subid')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-subid" min="0" class="form-control" name="row[subid]" type="number" value="{$row.subid|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Busid')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-busid" min="0" class="form-control" name="row[busid]" type="number" value="{$row.busid|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Total')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-total" min="0" class="form-control" step="0.01" name="row[total]" type="number" value="{$row.total|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Code')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-code" class="form-control" name="row[code]" type="text" value="{$row.code|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Couponid')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-couponid" min="0" class="form-control" name="row[couponid]" type="number" value="{$row.couponid|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Pay')}:</label>
        <div class="col-xs-12 col-sm-8">
                        
            <select  id="c-pay" class="form-control selectpicker" name="row[pay]">
                {foreach name="payList" item="vo"}
                    <option value="{$key}" {in name="key" value="$row.pay"}selected{/in}>{$vo}</option>
                {/foreach}
            </select>

        </div>
    </div>
    <div class="form-group layer-footer">
        <label class="control-label col-xs-12 col-sm-2"></label>
        <div class="col-xs-12 col-sm-8">
            <button type="submit" class="btn btn-primary btn-embossed disabled">{:__('OK')}</button>
        </div>
    </div>
</form>
